13,368 Individuals receiving Medicaid Waiver Program can lose their slots in FY 2011

[Guest guest]

From: The Arc of Texas

Sent: Tuesday, October 05, 2010 12:02 PM

Action Alert: Write Letters to

Governor's Staff by October 15, 2010

Write

Letters to Governor’s Staff by October 15, 2010

DADS

Legislative Appropriations Request— the agency baseline request DOES NOT

include funds to serve 13,368 individuals who are currently receiving

Medicaid Waiver Program and other community-based services or expected to

receive services by the end of FY11.

OUR

MESSAGE: “Maintain current DADS services!! Fund DADS Exceptional Items 1, 2

AND 3! Any cuts to DADS services would be DEVASTATING to individuals

and families.”

Address

your letter to Yoder (.Yoder@...).

In addition, send a copy of your letter to Amy Mizcles at amizcles@....

Information

to include in your letter:

Your name and address

Your affiliation with The Arc of

Texas (i.e. “I have been a volunteer with The Arc of Texas for 25

years…”)

How long you or your loved one was

on the waiting list

What life was like for you/your

loved one during the waiting period (details are important here!)

What program you/your loved one

currently receives

How the program services and

supports make your/your loved one’s life more meaningful (details are

important here!)

Describe what you/your loved one

would have to endure if services were cut after having waited so long;

how devastating would it be to you/your loved one (i.e. it

would be devastating AND I would go into a more expensive institution,

lose my job, lose my home, lose my marriage)

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Nagla:

The

Health and Human Services (HHS) agency Legislative Appropriations Requests

(LAR) were reviewed and public testimony was accepted during September’s

Joint Budget hearings between the Legislative Budget Board and the

Governor’s Office of Budget and Planning. The hearings were much

shorter than in previous years, with each hearing lasting between two and

three hours.

Given

the budget shortfall reality, now estimated at over $20 billion, it is

critical that staffers present at the September joint budget hearings hear

from other volunteers/members of The Arc. Yoder, with the

Governor’s Office, asked that letters be sent directly to her via email and

she promises to distribute the letters to all appropriate staff.

[Please copy amizcles@...

on that email so that we can follow up with staff at a later time.]

BACKGROUND:

In

January 2010, agencies were directed to reduce their current fiscal year

budgets by 5%. If you remember, the Health and Human Services

Commission (HHSC) was creative in making reductions and some HHS agency

budgets were reduced by 20% while others, like the Department of Aging and

Disability Services (DADS), were cut by less than 4%.

In May

2010, in a memo detailing LAR instructions from the LBB to agency heads,

agencies were directed to (1) adjust their baseline budgets to reflect a

full 5% reduction in General Revenue (GR) and (2) submit options (“a

supplemental schedule”) detailing how they would further reduce baseline

requests by an additional 10% in GR. So, as you can gather, the

LARs propose significant cuts to non-entitlement services and supports for

persons with intellectual and developmental disabilities (i.e. Medicaid

Waiver Programs, Community Center Safety-Net).

The DADS

LAR, submitted to leadership offices in August 2010 includes several items

that are of great concern to The Arc of Texas. First, the DADS

baseline budget request includes the following reductions: HCS Provider

Rate Reduction of 3.641% or $25 million GR, Community ICF/MR Rate Reduction

of 1.5%, and HCS Program Reductions of $2 million via Utilization Review

(authorizing fewer HCS services through UR).

Even

more troubling is that if certain DADS Exceptional Items are not funded,

13,368 Texans currently receiving Medicaid Waiver Programs & other

Community Based Supports will lose services!! They are:

DADS

Exceptional Item # 1: Return to regular FMAP after ARRA expiration

(Continue serving 8,090 individuals)

These

funds ($192.4 million GR) are needed to replace the FY10-11 level of ARRA

funding (higher FMAP) for Medicaid Waiver Programs. If this item is

not funded, individuals will lose services.

CBA =

-3,219

HCS =

-3,187

CLASS =

-861

DBMD =

-22

MDCP =

-427

CWP =

-23

TxHML =

-172

Program

of All –Inclusive Care for the Elderly (PACE) = -179

DADS

Exceptional Item #2: Annualization of Waiver Program (non-entitlement)

(Continue serving 5,278 individuals in waivers/PACE and 312 in non-waiver

services)

These

funds will maintain current services at August 2011 levels.

As the

expansion of community-based services has ramped up steadily over the

course of the biennium, the estimated number of individuals served in

August 2011 will exceed the average number of individuals served in FY10 or

FY11. However, the instructions for determining the baseline GR

funding limit for FY12-13 is based upon the two-year average GR level for FY10-11,

which is insufficient to fund the number of individuals served in August

2011. If this item is not funded, individuals will lose services.

CBA =

-2,099.9

HCS =

-2,079

CLASS =

-561

DBMD =

-15

MDCP =

-279

CWP =

-16

TxHML =

-112

Program

of All –Inclusive Care for the Elderly (PACE) = -117

Non-Medicaid

Services = -80

IDD

Community Services (Safety Net) = -48

In-Home

and Family Support Program = -184

DADS

Exceptional Item #3: Maintain FY2010-11 Service Levels—Cost Trends

(entitlement and non entitlement)

Per the

instructions, these funds would address rate increases, cost inflation, and

increases in utilization and acuity. DADS is experiencing increases

in the average cost per individual served in many programs as the result of

increased utilization or acuity. If this item is not funded,

individuals will lose services.

The

estimated annual (non-rate) inflationary cost trends are:

Entitlement

Programs

Primary

Home Care = 2.6%

Community

Attendant Care = 2.2%

Day

Activity and Health Services = 1.2%

Nursing Facility

= 1.8%

Medicare

Skilled Nursing Facility = 3.3%

Hospice

= 1.8%

Promoting

Independence Services = 0.9%

ICF =

0.1%

Waiver

Services

CBA =

0.9%

HCS =

0.0%

CLASS =

2.0%

DBMD =

2.0%

MDCP =

0.9%

CWP =

2.0%

Important

Note:

The Affordable Care Act (Federal Health Care Reform) has maintenance of

effort (MOE) requirements regarding the number of persons served in

waivers. While there have been no definitive guidelines from CMS, it

appears that the MOE will be established as the number of individuals who

were being served in March 2010. Without the restoration of ARRA

funding, the number of individuals served in these programs will have to be

reduced below March 2010 levels, which may jeopardize federal Medicaid

funding. It is critical that staffers in leadership offices hear

from us!! The bottom line is that in accordance with budget

writing instructions to agencies, the DADS baseline request does not

include funds to serve 13,368 individuals who are currently receiving

services or expected to receive services by the end of FY11.

We urge

you to write your letter today!

The Arc

of Texas Governmental Affairs Team

October

5, 2010

NOTE: The program budget information

contained in this action alert comes directly from the DADS Legislative

Appropriations Requests (LARs) for Fiscal Years 2012-13. To see the

document, go to: http://www.hhs.state.tx.us/.

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